Kraft Clara H, Pagenhardt Justine, Denne Nick, Minardi Joseph
Emergency Medicine, West Virginia University School of Medicine, Morgantown, USA.
Emergency Medicine, West Virginia University, Morgantown, USA.
Cureus. 2025 May 9;17(5):e83808. doi: 10.7759/cureus.83808. eCollection 2025 May.
A premenarchal female suffered recurrent abdominal pain for months before presenting to a critical access emergency department (ED), where point-of-care ultrasound (POCUS) finally revealed the underlying diagnosis of hematocolpos associated with imperforate hymen. Imperforate hymen, while rare, can lead to occlusion of the vaginal orifice during menarche, resulting in hematocolpos. Patients with hematocolpos can present with abdominal, low back, or pelvic pain, and delayed diagnosis may result in additional signs and symptoms, including tenesmus, constipation, urinary retention, and a palpable abdominal mass. Due to many potential etiologies of pediatric abdominal pain, attention to history of present illness and physical examination is critical to elucidate uncommon clinical diagnoses. POCUS is a safe, rapid, low-cost modality to evaluate the broad differential in pediatric abdominal pain. Early incorporation of POCUS may decrease diagnostic errors and patient morbidity associated with a delayed or inaccurate diagnosis.
一名青春期前女性在前往一家基层急诊室（ED）就诊前数月反复出现腹痛，在那里即时超声检查（POCUS）最终揭示了潜在诊断为与处女膜闭锁相关的阴道积血。处女膜闭锁虽然罕见，但在初潮时可导致阴道口闭塞，从而导致阴道积血。阴道积血患者可出现腹痛、下背部疼痛或盆腔疼痛，延迟诊断可能导致其他体征和症状，包括里急后重、便秘、尿潴留和可触及的腹部肿块。由于小儿腹痛有许多潜在病因，关注现病史和体格检查对于阐明罕见的临床诊断至关重要。POCUS是一种安全、快速、低成本的评估小儿腹痛广泛鉴别诊断的方法。早期采用POCUS可能会减少与延迟或不准确诊断相关的诊断错误和患者发病率。
